the expanded program on immunization

8/4/2019 The Expanded Program on Immunization

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Implementation of EPI contained in PDNo. 996 providing for compulsoryimmunization for infants and childrenbelow 8 years oldIn 1993, the number of EPI diseases wasexpanded from 6 to 7 with the inclusion ofhepatitis B


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FULLY IMMUNIZED CHILD one whohas received 1 dose of BCG at birth or anytime before reaching 12 months, 3 dosesof DPT and OPV with at least 4 weeksinterval between each dose, 1 dose ofmeasles at age 9 months or before 12

months, and 3 doses of hepatitis B with atleast 4 weeks interval between doses


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Vaccines in the EPI include BCG, DTwP,OPV, Measles and Hepatitis B.MMR and Hib are now part of the 2010DOH EPI


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Vaccine Age Dose Route AdverseReactions

BCG Newborn >1 mo

0.05 ml 0.1 ml

intradermal Abscess orulcers at site;

axillarylymphadeno-

pathy;

induration;pustular formn

DPT

(2-4-6)

6, 10, 14

weeks; 15-18mos, 4-6 years

0.5 ml intramuscular Fever,

convulsions,irritability,prolongedcrying (24-

48hrs)


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Given intradermallyShould be given at the earliest possibleage after birth, preferably within twomonths of lifePPD is not necessary for healthy infantsand children > 2 months of age who werenot given BCG at birth


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PPD is recommended before BCG vaccinationwhen:

Suspected with congenital TBWith history of close contact to known or suspectedinfectious cases of TBClinical findings suggestive of TB and/or chest X-raysuggestive of TB

In the presence of any of these conditions, aninduration of 5 mm is considered positive

The dose of BCG is 0.05 mL for infants


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Given subcutaneouslyGiven at 9 months of age but may begiven as early as 6 months of age in casesof outbreaks


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Given intramuscularlyThe first dose is given in a 3 dose primaryseries, at least 4 weeks apartA fourth dose is needed for the following:

If the 3 rd dose is given at age less than 6 monthsIf no birth dose is given using the EPI schedule of

6,10,14 weeksFor preterms less than 2 kg, the initial doseshould not be counted in a 3 dose immunizationschedule.


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Given subcutaneouslyMinimum age is 12 months

Administer second dose at age 4 through6 years2nd dose may be administered before age

4 provided an interval of 28 days haslapsed since the first dose


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Not part of the Philippine EPI

MMRV, Hepatitis A, DTaP, Tdap, IPV,Pneumococcal, Rotavirus, Influenza andHuman Papillomavirus


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Given subcutaneouslyCombination MMRV may be given as analternative to separately administeredMMR and Varicella vaccine for healthychildren 12 months to 12 years of age


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Given intramuscularlyMinimum age for PneumococcalConjugate Vaccine (PnCV) is 6 weeks andfor Pneumococcal Polysaccharide Vaccine(PPV) is at 2 years oldPPV is recommended for certain high risk

children 2 years of age in addition toPnCV.For healthy children, no additional dosesare needed if PnCV series is completed.


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Given intramuscularlyRecommended for children 12 months andaboveSecond dose is given 6-12 months afterthe first dose


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Per oremMonovalent (RV1) is given as a 2 dose seriesPentavalent human bovine rotavirus vaccine(RV5) is given as a 3 dose series1st dose is administered from the age of 6 weeksto 14 weeks and 6 daysMinimum interval between doses is 4 weeks2nd dose of RV1 should not be administered laterthan 24 weeks of age3 rd dose of RV5 should not be administered laterthan 32 weeks of age


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Given subcutaneously1st dose is administered at 12-15 months of age2nd dose is recommended at 4-6 years of age butmay be administered at an earlier age providedthe interval between the 1 st and 2 nd dose is at least3 monthsA 2nd dose is recommended for children,adolescents and adults who previously received

only one doseAll individuals aged 13 years and above, withoutprevious evidence of immunity should receive 2doses of varicella vaccine given at least 4 weeksapart.


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Given intramuscularly or subcutaneously6 months to 18 yearsChildren 6 months to 8 years receiving influenzavaccine for the first time should receive 2 doses ofthe vaccine separated by at least 4 weeksIf only one dose was administered during theprevious influenza season, administer 2 doses ofvaccine then one dose yearly thereafter

Children who receive a single dose of influenzavaccine for 2 consecutive years should continuereceiving single annual dosesPreferably be given between February to June


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Given intramuscularlyPrimary vaccination consists of 3 dose seriesadministered to females 10-18 years of ageRecommended schedule

Bivalent HPV: 0,1,6 monthsQuadrivalent HPV: 0,2,6 months

Minimum interval between the 1 st and 2 nd dose isat least one month and the minimum interval

between the 2nd

and 3rd

dose is at least 3 monthsUse in males 10-18 years of age for the preventionof anogenital warts is optional


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Given intramuscularlyFor children 10-18 years of age if they havenot completed the recommended childhoodDTwP/DTaP immunization series and if theyhave not received either Td or TdapTd booster every 10 years is recommended

Interval of at least 5 years from the last Tddose is recommended if Tdap is used asbooster to reduce the risk of local and

systemic reactions


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Rabies

Typhoid

Meningococcal


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Intramuscular or intradermalAnti-Rabies Act 2007 recommended routine rabiespre-exposure prophylaxis for children 5-14 yearsin areas where there is high incidence of rabies

(incidence >2.5 human rabies/million population)2 recommended regimensIntramuscular: PVRV of 0.5 mL or PCEC 1 mL ondeltoid area in days 0,7,21 or 28Intradermal: PVRV or PCECV 0.1 mL given in deltoidarea on days 0,7 and 21 or 28

Should never be given on the gluteal areabecause absorption is unpredicatable


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Given intramuscularlyRecommended for travelers to areaswhere there is high risk of exposure to S.typhi and for persons with frequentexposureSingle IM dose may be given as early as 2years of age with revaccination every 2-3years if there is continued exposure


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Intramuscularly or subcutaneouslySingle dose is recommended for all childrenaged 2 years known to be high risk for diseaseIn outbreaks, infants


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April 12, 2011

the expanded program on immunization

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